Blood glucose guidelines
Blood sugar guidelines Absolute numbers vary between pets, and with meter calibrations. The numbers below are as shown on a typical home glucometer while hometesting blood glucose, not necessarily the more accurate numbers a vet would see (though many vets use meters similar to those used in hometesting). For general guidelines only, the levels to watch are approximately: What's too high? At high readings, combined with inadequate administration of insulin, and not eating or drinking enough, or an infection, animals can sometimes quickly develop diabetic ketoacidosis (DKA), which is immediately life-threatening. Always check urine for ketones at high readings. Of course, cats at much lower levels who have inadequate insulin supply coupled with infection, dehydration, or fasting can also develop ketones. Some vets use a "sliding scale" regarding maximum permissible blood glucose values in dogs, "allowing" blind dogs or dogs with cataracts to use the concept of remaining under 250 mg/dL (13.88 mmol/L) at all times, with sighted dogs and dogs without cataracts ideally under 200 mg/dL (11.11 mmol/L). Others apply the "under 200" (11.11 mmol/L) for dogs at all times without exceptions. Evidence from humans, mice, and in-vitro tissue studies show that damage to the pancreatic beta cells (the ones that make insulin) continues down to levels as low as 140mg/dL (7.77 mmol/L). . This is why the AACE guidelines recommend average blood sugars (for humans) of no more than 170 mg/dL (9.44 mmol/L), preferably between 65 mg/dL (3.61 mmol/L) and 136 mg/dL (7.55 mmol/L). See hyperglycemia. Factors Which Can Affect Readings Why you still need Ketostix/Ketodiastix While home testing blood with a meter can tell you what your pet's blood glucose levels are, most can't do blood ketone testing. When you have high blood glucose levels, doing ketone testing with Ketodiastix or Ketostix is good practice to make sure your pet doesn't have ketones. Good BG Readings but Positive Ketone Results When the bg readings are high enough to produce some ketones, you've taken action to bring them down and they are normal once more, it is possible to still see some positive urine ketone test results. Ketones show up in the urine right away. When you're getting normal bg readings, it means that there are no more ketones being produced. What you are seeing when you test urine for ketones and the blood glucose is in normal ranges are the "leftovers" of the ketones which were produced by the high bg episode. They will continue to show up in the urine for a while but their concentration will become less and less until they're gone . Renal threshold -the point where glucose spills into the urine.]] The renal threshold for glucose is defined as the blood glucose level where the kidneys begin excreting excess glucose into the urine. Certain side effects on the urinary tract begin at this level, and it's also fairly close to the level where other organ damage seems to occur, though there's no actual causal relationship. This number is a bit different for every animal . Polyuria in diabetes shows that the body is unable to metabolize carbohydrates properly. Carbohydrates are turned into glucose, which is sent into the blood to feed the cells. The cells, lacking insulin, can't accept the glucose, so it remains in the blood causing hyperglycemia. The extra glucose in the blood accumulates there until the kidneys see it as an impurity to be filtered out and discarded. This point is known as the renal threshold. When the renal threshold is exceeded, and the excess glucose begins to spill into the urinary tract, the glucose makes the urine attract water in what's known as the osmotic effect. This extra water in the urine causes the excessive urination, dehydrating the body, which in turn causes the excessive drinking of polydipsia. While dogs and humans share the same renal threshold value of 180 mg/dl (10 mmol/L), the renal threshold of cats is 288 mg/dl (16 mmol/L); in cattle it's 108 mg/dl (6 mmol/L) . What's normal? Normal blood glucose values for non-diabetic cats and dogs range from 80-150 as measured on a vet's glucometer. Home glucometers used on animals tend to read a bit lower in the below-80 ranges because of the difference in size of red blood cells (erythrocytes) between species and so will frequently show lower numbers (see chart above) that are not cause for alarm. Diabetes being the "individual" disease it is, allows for many personal exceptions. A dog on the canine diabetes message board Canine Diabetes Message Board who was tightly controlled developed hypoglycemia symptoms every time his blood sugar dropped to 85 or below. The solution was to slightly reduce his insulin which kept him at slightly higher bg levels. Interpretation -a theoretical graph of what happens if you ignore the low bg numbers and focus only on the high ones created by the lows. As the insulin dose increases, the lows become lower, causing the counter-regulatory hormones to send the bg's higher in response. The only way to stop the extreme highs is to stop the lows; this means LESS insulin rather than more because it is the lows which are responsible for creating the highs .]] Note that no single blood glucose reading is adequate to establish insulin dosage or recommended treatment. Blood glucose levels should be checked before each shot, but that alone is also not enough to determine if treatment is working. Please see curve and regulation and duration for more information on this tricky subject. A single blood glucose reading is like a snapshot or a movie frame; it's a picture of how things were at that particular moment in time. While a movie frame can give us some information about its subject, it's when we put frame after frame together that we're able to see even more. If you see a cartoon of Mickey Mouse, you immediately recognize him, but Mickey really comes to "life" in animation. You see how he walks and talks, what he does and who his friends are. It's very much the same with blood glucose readings--the more of them you have, the easier it is to see where you're doing well and where you need to improve . Both people with diabetes and pets with diabetes fall into trouble when anyone starts "chasing the numbers", or as Dr. Mike Richards puts it, "chasing the glucose level". Changing insulin doses too frequently in search of the "perfect" blood glucose readings often winds up as hypoglycemia or Somogyi rebound, where the only way to correct the problem is LESS insulin rather than more. References More Information *Healthy Blood Sugar Targets (for humans, long term) Phlaunt *Blood glucose converter-mg/dl to mmol/L and vice-versa Children With Diabetes Category:Introduction Category:Regulation Category:Terms Category:Content Category:Charts